Hospital Based Therapy Billing

Grundy County Memorial Hospital recognizes that helping our customers understand the cost of health care and how they will be billed is a vital part of your health care experience. This information is intended to help you understand hospital billing and insurance reimbursement in advance of receiving therapy services at the hospital.

The service you are receiving at Grundy County Memorial Hospital (GCMH) is considered a "hospital-based outpatient service" according to private insurance guidelines. This means the way GCMH bills you for your care and how your insurance company calculates your benefit is different than if you were receiving care in a private therapy practice.

Here are common questions and answers regarding this billing method:

Q: What does "hospital-based outpatient" mean?
A: These services are considered part of the hospital, while private therapy practices are not. When you seek care from GCMH services such as physical therapy, you are being treated within the hospital rather than the therapy practice.

Q: Does this mean I will pay more for services in a hospital-based therapy department?
A: That depends on your insurance plan. We encourage you to review your insurance benefits or contact your insurance provider to determine how your policy will pay and what out-of-pocket expense will be your responsibility. You could pay more for your visit depending on your benefit plan, or the visit may be considered part of your annual deductible rather than a service eligible for a co-pay.

Q: What should I ask my insurance company?
A: 1. Ask whether your plan covers therapy services in a hospital-based outpatient service.
     2. If it does, ask what percentage of the charge is covered.
     3. Verify what your hospital outpatient insurance benefits are. They are typically applied toward a hospital deductible and coinsurance payment.

Q: What can I do if I am having difficulty paying for health care services?
A: Grundy County Memorial Hospital offers financial assistance to help qualifying patients and their families. Please contact the hospital's Financial Advocate at 319-824-4137. 

Thank you for choosing the Grundy County Memorial Hospital to serve your health care needs.